Kerr Jasmine I, Burri Andrea
Department of Psychology, University of Zurich, Zurich, Switzerland.
Department of Physiotherapy, Health and Rehabilitation Research Institute, Auckland University of Technology.
J Pain Res. 2017 Aug 24;10:2021-2029. doi: 10.2147/JPR.S143869. eCollection 2017.
The etiology underlying chronic widespread pain (CWP) remains largely unknown. An integrative biopsychosocial model seems to yield the most promising explanations for the pathogenesis of the condition, with genetic factors also contributing to disease development and maintenance. Here, we conducted a search of studies investigating the genetic and epigenetic epidemiology of CWP through electronic databases including Web of Science, Medline, PubMed, EMBASE, and Google Scholar. Combinations of keywords including CWP, chronic pain, musculoskeletal pain, genetics, epigenetics, gene, twins, single-nucleotide polymorphism, genotype, and alleles were used. In the end, a total of 15 publications were considered relevant to be included in this review: eight were twin studies on CWP, six were molecular genetic studies on CWP, and one was an epigenetic study on CWP. The findings suggest genetic and unique environmental factors to contribute to CWP. Various candidates such as serotonin-related pathway genes were found to be associated with CWP and somatoform symptoms. However, studies show some limitations and need replication. The presented results for CWP could serve as a template for genetic studies on other chronic pain conditions. Ultimately, a more in-depth understanding of disease mechanisms will help with the development of more effective treatment, inform nosology, and reduce the stigma still lingering on this diagnosis.
慢性广泛性疼痛（CWP）的病因在很大程度上仍然未知。一种综合的生物心理社会模型似乎对该病症的发病机制给出了最有前景的解释，其中遗传因素也对疾病的发展和维持起作用。在此，我们通过包括科学网、医学索引、PubMed、EMBASE和谷歌学术在内的电子数据库，对研究CWP的遗传和表观遗传流行病学的研究进行了检索。使用了包括CWP、慢性疼痛、肌肉骨骼疼痛、遗传学、表观遗传学、基因、双胞胎、单核苷酸多态性、基因型和等位基因等关键词的组合。最终，共有15篇出版物被认为与本综述相关并被纳入：8篇是关于CWP的双胞胎研究，6篇是关于CWP的分子遗传学研究，1篇是关于CWP的表观遗传学研究。研究结果表明遗传因素和独特的环境因素会导致CWP。发现各种候选基因，如血清素相关途径基因，与CWP和躯体形式症状有关。然而，研究显示出一些局限性，需要重复验证。所呈现的CWP研究结果可为其他慢性疼痛病症的遗传学研究提供模板。最终，对疾病机制更深入的理解将有助于开发更有效的治疗方法，为疾病分类学提供依据，并减少仍然萦绕在这一诊断上的污名化现象。
